MEDICARE: BOARD OF COUNTY COMMISSIONERS OF NASSAU COUNTY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	341600000X	Ambulance
2	341600000X	Ambulance	3712	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	406590904	OTHER	FL	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	159897600	OTHER	FL	US DEPT OF LABOR
2	N413568	OTHER	GA	WELLCARE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164422747
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BOARD OF COUNTY COMMISSIONERS OF NASSAU COUNTY

Provider Business Mailing Address
First Line	:	96135 NASSAU PL STE 2
Second Line	:
City	:	YULEE
State	:	FL
Zip	:	32097-8635
Country	:	US
Telephone Number	:	904-530-6030
Fax Number	:	904-530-6903

Provider Business Practice Location Address
First Line	:	96160 NASSAU PL STE 1
Second Line	:
City	:	YULEE
State	:	FL
Zip	:	32097-8626
Country	:	US
Telephone Number	:	904-530-6600
Fax Number	:	904-321-5748

Authorized Official
Title or Position	:	COUNTY MANAGER
Name	:	TACO POPE
Credential	:
Telephone Number	:	904-530-6010

Provider Enumeration Date	:	07/26/2005
Last Update Date	:	10/02/2023

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Directions to “BOARD OF COUNTY COMMISSIONERS OF NASSAU COUNTY ” Practice Location

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